In this project we will examine ethnic and gender differences in (1) the development and use of informal caregiving practices that spouses employ in the home to take care of and manage the Alzheimer's patient, and (2) family caregivers, consideration of and possible turn to formal caregiving strategies, including support groups, respite and in-home care, day care, and perhaps ultimately institutionalization. Specific attention will be given both to the nature and consequences of management practices developed to control the behavior of the person with Alzheimer's, and to that person's cooperation with or resistance to the caregiver's care and control efforts. The research will employ qualitative in-depth interviews at six month intervals over a two year period with a final sample of 60 Hispanic and Anglo Alzheimer spousal caregivers. Our research design will also entail participant observation field research focused on gatekeeping and entry processes at agencies that either assess family caregiving needs and link family caregivers with formal services, or that directly provide such services. These procedures will allow in-depth longitudinal analysis of the experience and practices of informal family caregiving, and of the processes of transition to formal care, including caregivers, efforts to find out about, contact, assess, arrange for and implement such care. Ethnic and gender variations in these processes will be brought out and analyzed.